rss

This article has a correction

Please see: BMJ Case Reports 2009;2009

BMJ Case Reports 2009; doi:10.1136/bcr.07.2008.0394
  • Reminder of important clinical lesson

Diffuse mesangial IgA glomerulonephritis in a patient with rheumatoid arthritis: a possible extra-articular manifestation in rheumatoid arthritis

  1. Lyubomir Marinchev1,
  2. Svetla Atanasova2,
  3. Raina Robeva2,
  4. Todor Todorov3
  1. 1
    University Hospital, Rheumatology, 13 Urvitch, Sofia, 1612, Bulgaria
  2. 2
    University Hospital “St. Ivan Rilsky”, Internal Medicine and Nephrology, 15 Ivan Geshov Boulevard, Sofia, 1431, Bulgaria
  3. 3
    University Hospital “Alexandrovska”, Pathology, 1 “Georgi Sofiiski” Street, Sofia, 1431, Bulgaria
  1. Lyubomir Marinchev, Lubommar{at}gmail.com
  • Published 18 June 2009

Summary

Rheumatoid arthritis (RA) is an inflammatory joint disease, in which, unlike systemic lupus erythematosus (SLE), renal involvement is uncommon. The major causes of renal disease in RA are usually linked to amyloid or secondary effects of drugs. Nevertheless the relation between IgA, IgA-rheumatoid factor (RF) and renal disease in patients with RA is not clear, but the affinity of IgA for mesangium, skin and synovium might explain clinical presentation of RA with mesangial IgA glomerulonephritis. The case of a 42-year-old Caucasian man with RA and diffuse mesangial IgA glomerulonephritis proven by renal biopsy is presented. The patient was treated with boluses of methylprednisolone 1000 mg and cyclophosphamide 1000 mg monthly for 13 months. Between boluses there was a supported therapy with methylprednisolone 8 mg/day. After a year of treatment full clinical and laboratory remission of RA and IgA glomerulonephritis was achieved. Pathogenic therapy will be stopped and the patient followed-up.

Footnotes

  • Competing interests: None.

  • Patient consent: Patient/guardian consent was obtained for publication.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article